Cover-up, camouflage and avoidance: those are often the behaviour patterns of people with the inflammatory skin condition known as psoriasis.

It’s down to feeling self-conscious and perhaps embarrassed about the plaques and the shedding skin that characterise the condition. Strip off to get into a swimming pool? You must be joking. Wear a sleeveless dress? Not on your life. Bare all on the beach? Impossible.

But how can the one in 50 people in Ireland with psoriasis move past these feelings of discomfort to more acceptance of the condition and more self-confidence?

Dr Eddie Murphy, the clinical psychologist well known from RTÉ’s Operation Transformation programme is trying to inspire people with psoriasis to do just that. “The impact of psoriasis on people’s quality of life can be quite significant,” he says.

With 100,000 people in Ireland having this chronic, auto-immune condition, he is now an ambassador for the #Askhowifeel campaign. This campaign is being supported by the Irish Skin Foundation and Novartis to support people get away from these traditional reactions.

His involvement with the group of people with psoriasis is about helping them overcome the challenges that they are experiencing. “There is an emotional toll to psoriasis,” Dr Murphy agrees. From a psychological point of view, skin is interesting, he says. “It’s the visibility of skin and how people perceive their skin and how they are worried about how others might see them.”

He believes that treating both the emotional and physical aspects of psoriasis is important. “That’s in order to have the best quality of life possible. I believe doing that can make a massive difference.”

BE MORE OPEN ABOUT THE CONDITION

He wants those with psoriasis to be more open about their condition, he says, and others to be more aware also. “It’s about approaching the condition from the inside out, supporting people to empower them to not suffer in silence.

“It’s about starting to look at the whole area of confidence and self-esteem and how psychology and CBT (cognitive behavioural therapy) tools can be used in supporting individuals around that,” explains Dr Murphy.

A recent Burden of Psoriasis report carried out by Novartis showed that anxiety and depression can be significant issues for those with psoriasis.

The condition is preventing many people engaging fully with life too, the research showed. In all, 57% said, for instance, that it stopped them from taking part in activities they love; 93% said it caused them embarrassment; and 54% said it affected their love lives.

Having psoriasis does affect family life, he states, and can be worsened by the existence of myths around the condition. “One is that psoriasis is contagious. That’s not true. It is not an infection. It’s an auto-immune disease.

“Some people have the mistaken belief also that it’s due to poor hygiene, but they couldn’t be more wrong. We know it is triggered by a combination of genes and environmental factors and has nothing to do with that.”

HONESTLY DISCUSS THE IMPACT

The #Askhowifeel campaign is encouraging those with psoriasis to have more open conversations about the impact it has on their lives. “We’re encouraging those around them – friends, family and healthcare professionals – to honestly discuss both the physical and the emotional experience of their condition too.”

In terms of action, Dr Murphy is not telling people to “focus on the positive”, he states. “I don’t say that. If you say that, people often feel that you’re discounting what they are actually feeling. Instead, I say: ‘Focus on the balanced information.’”

He tells of a person named Mary, who has psoriasis and who would like to go to the local pool, for example, but decides against it. “She avoids going because she thinks: ‘What will people think of me?’ Reactions she experienced before may have been that people stepped back, which made her think that there is something wrong with her. The CBT tools involve tackling thinking like that.

“Cognitive means thinking and behavioural means behaviour. Change the thinking and you can change the behaviour. Quite often people filter only the negative information and discount the positive or neutral information they receive.

“Part of coping better with psoriasis is saying: ‘Well, some people might react like that, but there are many more people who won’t react like that.’ It’s about balanced thinking, moving toward acceptance and the opposite of avoidance by tackling the (negative) thoughts, step by step.”

BETTER STRESS MANAGEMENT

Because stress can trigger flare-ups of skin conditions like psoriasis, it is important to get better at managing one’s stress, he adds. He recommends the free SymTrac app that helps those with psoriasis track their symptoms. “It can help with managing the condition, as patients can notice patterns in flare-ups and whether or not these patterns are related to stress. They can also have all this information related to their psoriasis to hand when they see their GP.”

Campaigners for #AskhowIfeel are asking those with psoriasis to admit to friends and health professionals if they are struggling emotionally because of psoriasis. “While I have no data about how many people with psoriasis experience depression, some people do feel depressed about it and it’s important to say that and seek guidance around it.”

There is a lot of quackery around psoriasis also, he says, which people must navigate away from. “A lot of people are pushed down pathways that may not be good, trying to find a cure. The Irish Skin Foundation, however, gives solid information to support people with psoriasis to have a greater quality of life.”

Moving away from cover-up and camouflage behaviour towards acceptance, higher levels of confidence and self-esteem is the answer. “It helps people re-engage in life, which in turn increases quality of life,” he concludes.CL

The Irish Skin Foundation

The Irish Skin Foundation (ISF) is a national charity supporting people with a lot of different skin disorders. It provides support and advocacy. The ISF also operates a telephone and email helpline for people affected by all types of skin disease in Ireland. The ISF Helpline is open from Monday to Friday from 10am to 4.30pm. Telephone (01) 486 6280 or send your question to https://irishskin.ie/ask-our-dermatology-nurse. General queries can be answered or the dermatology nurse will call you back. See www.irishskin.ie for more.

free public information evening – TONIGHT (3 MAY 2018)

Dr Eddie Murphy will be one of the speakers at a free public information evening for people living with psoriasis and their families. It takes place from 6pm to 7.30pm at the Alex Hotel, Dublin 2. See www.askhowifeel.ie for more information.

Common sheep and cattle ticks as well as those found on deer can bite humans and make them ill. That’s if the ticks are carrying the Lyme Borreliosis infection – and 20% of Irish ticks are, experts say.

Lyme disease can cause flu-like symptoms and sometimes a bull’s eye rash initially, followed by numbness and chronic joint pain and even worse if not treated.

It was first recorded in Ireland in 1987 and is now more prevalent because of the increase in Red and Sika deer populations coupled with climate change, re-afforestation and the re-appearance of rough grazing areas due to set-aside policy and part-time farming practices.

These all contribute to providing an ideal environment for ticks to survive and reproduce, according to scientist Dr Eoin Healy.

Anywhere up to 20% of ticks on farms and in the countryside will carry Borrelia bacteria, the infective agent that causes Lyme disease.

TICK BITE AND INFECTION

Ticks climb onto grass stems and heather, then wait for a passing animal – a possible “host”. The ticks are attracted to CO2 – from the breath and body of an animal or human, so they grab the opportunity to cling to any skin or fur they come in contact with.

The tick needs a blood feed to survive, and it secretes an anaesthetic into your skin so that you may not know you’ve been bitten.

“It is quite possible that a tick might attach, say behind a person’s knee, feed for several days and then drop off without the victim being aware they’d been bitten,” he says.

The infection, if the tick carries it, goes into the person’s blood stream from the bite site and may attack several organs.

“A red, circular rash – a bull’s eye ring – is the main diagnostic indicator of infection. It usually appears within a few days of being bitten, but only 80% of those who develop Lyme disease get the rash.” Doctors in Ireland are now becoming more aware of Lyme disease, but it can be difficult to diagnose, however.

LYME DISEASE CONFERENCE

The 2018 National Lyme Disease Conference will take place on Saturday 2 June at Astra Hall, UCD, Dublin 4. It costs €40 and you can book at www.ucd.ie/medicine/lyme18 CL

For more information, visit www.ticktalkireland.org.